Transapical removal device

Abstract

A transapical removal device that can be deployed in a catheter procedure to capture for removal or alteration a mitral valve clip or heart tissue, such as the anterior leaflet of the mitral valve, and methods of use are disclosed. The removal device includes a delivery catheter configured to be deployed near a mitral valve using a guide catheter. The delivery catheter has a snare head at the distal end, which assumes a collapsed state during movement of the delivery catheter through the guide catheter and deployed state for capturing a mitral valve clip or anterior leaflet. The snare head has one or more ablation delivery catheters configured to ablate tissue surrounding the pre-positioned mitral valve clip or anterior leaflet. In some arrangements within the scope of the present disclosure, the removal device includes a deployment mechanism for deploying a new transcatheter valve into the mitral valve.

What is claimed: 
     
         1 . A device to remove a valve clip pre-positioned on a heart valve leaflet comprising:
 a delivery catheter having a distal end portion configured to be positioned near a heart valve;   a grasping tool deployable from the distal end portion of the delivery catheter, the grasping tool configured to grasp and manipulate the valve clip; and   a removal tool extendable relative the distal end portion of the delivery catheter, the removal tool configured to at least partially surround the valve clip and to remove the valve clip from the heart valve leaflet.   
     
     
         2 . The device of  claim 1 , further configured to collapse the valve clip for removal from a heart. 
     
     
         3 . The device of  claim 1 , wherein the grasping tool is configured to be moveable between an open state and a closed state. 
     
     
         4 . The device of  claim 3 , wherein the grasping tool includes a grasping element disposed within an actuation tube deployable from the distal end of the delivery catheter, the grasping tool is configured to move from the closed state to the open state when the grasping element is moved outside the actuation tube, and the grasping tool is configured to move from the open state to the closed state when moved into the actuation tube. 
     
     
         5 . The device of  claim 1 , wherein the removal tool comprises a snare basket. 
     
     
         6 . The device of  claim 5 , wherein the snare basket comprises a distal open end to receive the valve clip. 
     
     
         7 . The device of  claim 6 , wherein the removal tool comprises a cord to cinch the snare basket closed. 
     
     
         8 . The device of  claim 5 , wherein the snare basket comprises a first basket side and a second basket side moveable relative each other to capture the valve clip therebetween. 
     
     
         9 . The device of  claim 5 , wherein the snare basket comprises at least one of a medical-grade plastic, a medical-grade metal, and a shape memory material. 
     
     
         10 . The device of  claim 1 , wherein the removal tool comprises an ablation device. 
     
     
         11 . The device of  claim 10 , wherein the ablation device comprises at least one electrode to supply radiofrequency energy to ablate the heart valve leaflet. 
     
     
         12 . The device of  claim 10 , wherein the ablation device comprises an optical fiber to deliver a laser ablation signal to ablate the heart valve leaflet. 
     
     
         13 . The device of  claim 10 , further comprising an ablation source in communication with the ablation device, wherein the ablation source is one of a radiofrequency source, laser source, and cryo-thermal source. 
     
     
         14 . The device of  claim 13 , wherein the ablation source is a radiofrequency signal in a range of 250-500 kHz. 
     
     
         15 . The device of  claim 1 , further comprising a controller configured to control at least one of the removal tool and the grasping tool. 
     
     
         16 . A method to remove a valve clip pre-positioned on a heart valve leaflet comprising:
 delivering, to a chamber of a heart, a removal device, the removal device comprising:
 a delivery catheter having a distal end portion configured to be positioned near a heart valve, 
 a grasping tool deployable from the distal end portion of the delivery catheter, the grasping tool configured to be moveable between an open state and a closed state to grasp and manipulate the valve clip, and 
 a removal tool extendable relative the distal end portion of the delivery catheter, the removal tool configured to at least partially surround the valve clip and to remove the valve clip from the heart valve leaflet; 
   deploying the grasping tool from the open state to the closed state to grasp a first portion of the valve clip;   at least partially surrounding the valve clip with the removal tool; and   removing the valve clip from the heart valve leaflet using the removal tool.   
     
     
         17 . The method of  claim 16 , further comprising collapsing the valve clip for removal from a heart. 
     
     
         18 . The method of  claim 16 , wherein the grasping tool is movable between an open state and a closed state, the grasping tool includes a grasping element disposed within an actuation tube deployable from the distal end of the delivery catheter, and wherein deploying the grasping tool comprises moving the grasping element outside the actuation tube to move the grasping tool from the closed state to the open state. 
     
     
         19 . The method of  claim 16 , wherein the removal tool comprises a snare basket, and at least partially surrounding the valve clip comprising positioning the snare basket to at least partially surround the valve clip. 
     
     
         20 . The method of  claim 19 , wherein the snare basket has an open distal end to receive the valve clip, and wherein the method further comprises cinching the snare basket around the valve clip. 
     
     
         21 . The method of  claim 19 , wherein the snare basket comprises a first side and a second side moveable relative each other, and at least partially surrounding the valve clip comprises capturing the valve clip between the first side and the second side. 
     
     
         22 . The method of  claim 16 , further comprising removing the valve clip through the delivery catheter when the valve clip is in a collapsed state using the removal tool. 
     
     
         23 . The method of  claim 16 , wherein the removal tool comprises an ablation device, and further wherein removing the valve clip from the heart valve leaflet comprises ablating the heart valve leaflet using the ablation device. 
     
     
         24 . The method of  claim 23 , wherein ablating the heart valve leaflet comprises delivering radiofrequency energy to the heart valve leaflet using the ablation device. 
     
     
         25 . The method of  claim 23 , wherein ablating the heart valve leaflet comprises delivering a laser ablation signal to the heart valve leaflet using the ablation device.